Department of Family Medicine and Community Health, University of Wisconsin, School of Medicine and Public Health, 1100 Delaplaine Ct, Madison, WI 53715, United States of America.
College of Pharmacy Substance Use Research and Education (SURE) Center, United States of America; Department of Family and Community Medicine, United States of America; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 09 5360, Albuquerque, NM 87131, United States of America.
Neurotoxicol Teratol. 2021 May-Jun;85:106974. doi: 10.1016/j.ntt.2021.106974. Epub 2021 Mar 22.
Longitudinal cohort studies present unique methodological challenges, especially when they focus on vulnerable populations, such as pregnant women. The purpose of this review is to synthesize the existing knowledge on recruitment and retention (RR) of pregnant women in birth cohort studies and to make recommendations for researchers to improve research engagement of this population. A scoping review and content analysis were conducted to identify facilitators and barriers to the RR of pregnant women in cohort studies. The search retrieved 574 articles, with 38 meeting eligibility criteria and focused on RR among English-speaking, adult women, who are pregnant or in early postpartum period, enrolled in birth cohort studies. Selected studies were birth cohort (including longitudinal) (n = 20), feasibility (n = 14), and other (n = 4) non-interventional study designs. The majority were from low-risk populations. Abstracted data were coded according to emergent theme clusters. The majority of abstracted data (79%) focused on recruitment practices, with only 21% addressing retention strategies. Overall, facilitators were reported more often (75%) than barriers (25%). Building trusting relationships and employing diverse recruitment methods emerged as major recruitment facilitators; major barriers included heterogeneous participant reasons for refusal and cultural factors. Key retention facilitators included flexibility with scheduling, frequent communication, and culturally sensitive practices, whereas participant factors such as loss of interest, pregnancy loss, relocation, multiple caregiver shifts, and substance use/psychiatric problems were cited as major barriers. Better understanding of facilitators and barriers of RR can help enhance the internal and external validity of future birth/pre-birth cohorts. Strategies presented in this review can help inform investigators and funding agencies of best practices for RR of pregnant women in longitudinal studies.
纵向队列研究提出了独特的方法学挑战，尤其是当它们关注孕妇等弱势群体时。本综述的目的是综合现有的关于招募和保留（RR）孕妇的知识，并为研究人员提出建议，以提高该人群的研究参与度。采用范围综述和内容分析来确定队列研究中 RR 孕妇的促进因素和障碍。检索到 574 篇文章，其中 38 篇符合入选标准，主要关注英语为母语的成年孕妇在队列研究中的 RR，她们处于怀孕或产后早期，参与了出生队列研究。入选的研究包括出生队列（包括纵向）研究（n=20）、可行性研究（n=14）和其他（n=4）非干预性研究设计。大多数研究来自低风险人群。根据新兴主题群集对提取的数据进行编码。提取数据的大部分（79%）侧重于招募实践，只有 21%涉及保留策略。总体而言，促进因素的报告频率（75%）高于障碍（25%）。建立信任关系和采用多样化的招募方法被认为是主要的招募促进因素；主要障碍包括参与者拒绝的原因和文化因素的多样性。主要的保留促进因素包括灵活的日程安排、频繁的沟通和文化敏感的做法，而参与者的因素，如失去兴趣、妊娠丢失、搬迁、多个照顾者轮班和物质使用/精神问题，被认为是主要的障碍。更好地了解 RR 的促进因素和障碍可以帮助提高未来出生/产前队列的内部和外部有效性。本综述中提出的策略可以帮助告知研究人员和资助机构在纵向研究中招募孕妇的最佳实践。
